Harvard Public Health Review/Summer 2002

random samples

Dangerous Liaisons

Teenage girls today seem more in charge and confident than ever, striding down
the street pierced, tattooed, and provocatively dressed like their older sisters,
clutching cell phones and cigarettes, and ever quick with a comeback for the weary
parent or teacher. Yet findings from a recent Harvard School of Public Health
study indicate that the image of teenage "girl power" may be far from
accurate. One in five girls between the ages of 14 and 18 report being hit, slapped,
or forced into sexual activity by their dating partners, according to the research
led by Jay Silverman, director of Violence Prevention Programs at the School's
Division of Public Health Practice and assistant professor of health and social
behavior.

"We saw relatively high levels of dating violence in all ethnic and racial
groups we looked at," says Silverman. The study, published in the Journal
of the American Medical Association, summarized results from 4,163 girls across
Massachusetts who participated in the 1997 and 1999 Massachusetts Youth Risk
Behavior Surveys. In both years, almost 75 percent of the participating students
were white, with smaller percentages of Hispanic, black, and Asian students.
"The temptation of many is to assume there is profile of those who are
truly at risk--that it won't happen at my school because it doesn't
happen to these kinds of kids. This kind of thinking is a tremendous mistake
and disservice," he emphasizes. Silverman considers dating violence a huge
public health problem because of the high prevalence rates and the broad array
of associated health risks found in the study. "Girls who experience dating
violence are also more likely to become pregnant, smoke heavily, abuse alcohol
and other substances, use laxatives and vomiting for weight loss--and they
are more vulnerable to suicide," he explains.

And what about their boyfriends? Male adolescents often repeat violent behaviors
they see modeled at home and are encouraged by friends who are also abusive,
says Silverman. He explains teenage dating violence in the context of the broader
culture of the United States, where more than 1.5 million women are physically
and/or sexually abused by an intimate partner each year and 25 percent of all
women experience violence from their partners at some point during their lifetimes.
"We've seen lots of other types of crime go down, but when you look
in the literature, one of the few areas to remain stable is violence against
women," he notes. In a culture that accepts these rates of gender-based
violence, it is not surprising that boys feel entitled to control their girlfriends.
As Silverman illustrates: "A jealous or angry teenage boy may think, 'She
has no right to do that--I'm the man and have the right to stop her.'"

Understanding that gender-based violence is different than other types of violence
is critical in structuring prevention programs for teenagers, says Silverman.
He advocates training adults who work with teenagers, including teachers and
pediatricians, to identify girls who may be in abusive relationships and directing
them to prompt, confidential help. But, he is quick to add, "We must hold
boys accountable for their behavior. While girls should receive as much information
and support as possible, it's not reasonable to assume that the way to
prevent dating violence is for girls to have an amazing system to detect potentially
violent dating partners--abusive behavior is often not evident in the initial
stages of a relationship." Silverman recommends additional research to
better understand and redirect boys who abuse their girlfriends. He notes that
Massachusetts has begun to set up pilot programs to work with abusive teenage
boys--the only state to fund these kinds of initiatives: "We're beginning
to look at boys referred from youth services, the criminal justice system, and
the Department of Social Services--but this is just the tip of the iceberg of
those who perpetrate these behaviors."